Two Cases of Rectal Hemorrhage Requiring Surgical Hemostasis

概要

論文の詳細を見る
We report two cases of rectal hemorrhage requiring surgery to achieve hemostasis. The first patient was a 76-year-old woman hospitalized to treat lumbar pyogenic spondylosis. She was treated with antibiotics and bed rest. On the 7th day of admission, massive lower gastrointestinal bleeding occurred; colonoscopy revealed an irregular-shaped ulceration with pulsating bleeding from an exposed vessel in the lower rectum, which we diagnosed as acute hemorrhagic rectal ulcer (AHRU). The bleeding was stopped by clipping performed that day, but massive bleeding recurred. We finally achieved hemostasis with transanal suturing. The second patient was an 83-year-old woman hospitalized to treat hemorrhagic cerebral infarction. On the 9th day of admission, massive lower gastrointestinal bleeding occurred, which we diagnosed as AHRU based on clinical and colonoscopy findings. It was difficult to achieve hemostasis, so we performed laparotomy. We finally made a diagnosis of bleeding from rectal diverticula, and performed a Hartmann operation. Lower gastrointestinal bleeding can lead to massive hemorrhage. Therefore, elderly patients with lower gastrointestinal bleeding need rapid treatment, which may include surgical hemostasis.